Effectiveness of Modified Constraint-Induced Movement Therapy Versus Mirror Therapy in Spastic Hemiplegic Cerebral Palsy Children

Overview

This randomized controlled trial was conducted to compare the effectiveness of Modified Constraint-Induced Movement Therapy (MCIMT) and Mirror Therapy in improving upper limb function among children with spastic hemiplegic cerebral palsy. Upper limb dysfunction, including reduced grip strength, impaired manual dexterity, and increased spasticity, limits functional independence and participation in daily activities in these children. Although both interventions are widely used in pediatric rehabilitation, direct comparative evidence remains limited. A total of 42 children aged 5-9 years diagnosed with spastic hemiplegic cerebral palsy were recruited from Akbar Kare Institute and Comprehensive Physical Rehabilitation Center, Peshawar. Participants were selected through convenience sampling and randomly allocated into two equal groups using the sealed envelope method. Group A received Modified Constraint-Induced Movement Therapy, while Group B received Mirror Therapy. Both groups received treatment for 30 minutes per session, five sessions per week, for six consecutive weeks. Grip strength was assessed using the Hand-Held Dynamometer, manual dexterity using the Box and Block Test, and spasticity using the Modified Ashworth Scale. The findings of this study provide evidence regarding the comparative effectiveness of these two rehabilitation approaches and may assist clinicians in selecting the most appropriate intervention for improving upper limb function in children with spastic hemiplegic cerebral palsy.

This study employed a parallel-group randomized controlled trial design to evaluate the comparative effectiveness of Modified Constraint-Induced Movement Therapy and Mirror Therapy. Following ethical approval, eligible participants were recruited according to predefined inclusion and exclusion criteria. After obtaining informed consent from parents or guardians, baseline assessments were performed. Participants were randomly assigned to one of two intervention groups. Both groups received standardized treatment sessions lasting 30 minutes, five days per week for six weeks. Outcome measures included grip strength measured with a Hand-Held Dynamometer, manual dexterity measured using the Box and Block Test, and spasticity measured using the Modified Ashworth Scale. Assessments were conducted before and after completion of the intervention period. Statistical analysis was performed using SPSS Version 26 with a significance level of p \< 0.05.